disaster management and incident command Flashcards
national incident management system (NIMS)
standardized approach, est by homeland security after 9/11
incident
natural disaster, act of terrorism, failing infrastructure, transportation
NIMS: benefits
standard organizational structures, processes, procedures
national standards for planning, training, exercising
personel qualification standards
interoperable comm processes, procedures systems
info management with commonly accepted architecture
support tech and infrastructure, comm systems, info systems, specialized tech
web
look at/draw on board
incident commander
create unified command btw responding agencies
answer to gov
point of contact
eval incident
create and oversee plan of action
determine needs based on size of incident
benefits of incident commander
use of common lang and clear text ensures better comm
point of command for modular organizational structure limiting duplication in efforts
has final operational say and control
safety officer
monitor hazards in day to day operations
no further incidents
enforce safety plan for scene operations
assist in dev emergency repsonse plans if further incidents ensue
public info officer
comm info to public and media
comm facts and viewpoint of responding/controlling agency
usually local for victim names
usually only speaks to response efforts and operations: disclosure/announce deaths to media/press
liaison officer
relay info btw incident commander, general staff, other angencies
large scale repsonse usually has group that report to chief
daily and hourly briefs
key purpose to asssist in comm btw departments and field reponse efforts
finance/admin section
doc all expenses to be reimbursed (fed and state $)
track: time unit hrs worked, cost of supply procurement, cost of compensation and claims, track $ of bringing supplies in and out
logistics section
branches: service and support
facilities, med repsonse, food and H2O, equip and supplies
movement of equip and supplies: many services contracted by FEMA in advance
planning section
in charge of problem solving issues as they come up
predict and plan next phase of response
dev of demobilization plan (start when response initiated), incident/emergency action plan
operations section
manage and plan day to day response
oversee all field operations
have chain of command with system of reporting to comm field operations back to command
prevent redundant clear comm
standard comm
post 9/11
radio freq -> prevent redundant
standard naming of equipment assets -> firetrucks (most have command center in trunk)
NIFOG outlines naming and freq
mobilizaiton and deployment
needed resources identified + sources from local and national agencies
agencies notified and informed of reosurces needed, along with expected response time
each resource is responsible for tracking cost to submit to finance
upon arrival, incident commander will brief the individuals and provide them with theri detail -> plan of day
medical incident command
3 wings: triage, tm, transport
all responses overseen by designated med director
triage
triage and tag all pts, remove from site, work closely with tm and extrication supervisor, ensure adequate personnel to quickly and efficiently assess pts, est morgue prn (out of way and concealed from public eye), doc triage process
prioritize and sort sick or injured for tm according to seriousness of condition or injury
treatment
reparate pts into priority groups
assign to treat
ensure sufficient supplies and personnel
maint security (away from further R or exposure) of tm area and that pts are decontaminated
work with transport supervisor to arrange transport
provide updates to EMS director
transportation
in charge of all pt movement from tm area
est loading zeon for pt transport
determine appropriate destination for pt based on needs (trauma v burn facility)
track and doc all pt transport
additional supervisors on med scene: staging
run staging location
est entrance and exit to site, main job to prevent traffic congestion
additional supervisors on med scene: physician on scene
provide on site med direction
additional supervisors on med scene: rehab
onsite rehab, monitor personnel for s/s stress and fatigue (rest and hydrate)
multiple casualty incidents
3+ pts
req mutual aids (not enough local resources) and strains resources
declare if more resources needed
MCE if >100
MCI: types - open incidents
unknown amount of casualties
req search and rescue
normally long and ongoing
MCI: types - closed incidents
of pts not expected to change
pt triaged, treated, removed from scene
can become open incident if outside bystander enter in response
triage: sorting
cant commit to 1:1 care
fast <30s/pt
v limited tm: manually open airway, clear airway with finger sweep or head positioning
instruct pt or bystander to control major bleed
triage: types
same basic steps
MASS: move, assess, sort, send
ESI: emergency severity index
SALT: sort, assess, lifesaving intervention, treat/transport
start/jumpstart (peds): simple triage and rapid tm, US gold standard
triage: primary
on scene prior to transport
at hospital if arrived by foot or personal vehicle
triage: secondary
incident dependent, probably prior to or during transport
at receiving facility
ongoing process -> never stops
START: general
1983, staff members of newport beach FD
easy, focus on s/s, fast
START: 4 focus points
sort with newest person bc most objective
ability to follow directions and walk
resp effrot
pulse (radial)/perfusion
mental status
tags: black
expectant
unlikely to survive injuries and/or level of cre
provide palliative and pain control
tags: red
immediate
can be helped by immediate intervention and transport
re med attention w/n 60 min to survive
ABC compromise/RPM (resp, pulse, mental status)
tags: yellow
delayed
transport can be delayed
serious and potentially life threatening, but status is not expected to deteriorate significantly over several hrs
tags: green
minor
relatively minor injuries
status unlikely to deteriorate over days
assist in own care -> walking woudned
critical incident stress management (CISM)
prevent long term psych impact
emergency workers may suffer psych impact
need to include resources for debriefing and defusing responders
this team should be avail at all times during response efforts
participation encouraged by not req
after action review
detailed review of response and action conducted
all obs need to be recorded and doc for future review
never accuse someone of wrongdoing during response -> learning process
become public -> table top exercise
role of nurse: planning
dev comm repsonse plans
edu comm on prevent and response plans
provide expert knowledge on response plan dev
role of nurse: response - scene
triage and primary care
assist in searches and assess
role of nurse: response - hospital
staff assist in influx
assist in executing emergency plan
role of nurse: response - comm response
respond to shelters to assist in med care of those in need
role of nurse: response - after care
assist in returning comm to normal
make sure resources are re-est in comm
provide med and mental hc to responders
role of nurse: disaster response plans
be familiar with facility response plans for different types of disasters
know local resources for disaster management: EMS, hospital capabilities
be familiar with threats in area
practice!
